Thirteen days ago I had knee surgery to repair my ACL in my left knee, and this morning I saw my surgeon to follow up about it. First, his nurse removed my (17) staples. Then he showed me pictures from the surgery (two of which I’ll share momentarily) and said it went well. In terms of my progress, he seemed impressed, especially with the facts that I’m off crutches, out of a brace, and bending my knee more than 90 degrees. “If I were being picky, I’d say you need to straighten your leg more, but it’s not bad,” he said.
Ever the perfectionist, I now have a new goal.
The surgeon said I should see continual progress for the first two or three months. “That’ll be exciting and keep you motivated,” he said. “But then you’ll forget anything was ever wrong, and whereas I want you to forget at some point, I don’t want you to forget before six months and do something stupid like jump a ditch.” Then he explained that six months is how long it takes to get blood flowing to the newly constructed ACL, which is why I have to be ever-so-gentle with it until then. That means no swimming, jumping, or planting and turning (as in spinning, pivoting, or–um–dancing).
Here’s a picture of my old ACL. It looks sad, frayed, and lifeless because I completely tore it away from the bone. Personally, it reminds me of sushi.
Here’s a picture of my new ACL, which the surgeon constructed from my patellar tendon. Talk about pretty. (Don’t be jealous; I’m sure yours looks nice too.) Note that tendons are stronger than ligaments, which is why some surgeons (mine included) prefer to reconstruct the ACL (a ligament) using the patellar tendon (a tendon, duh) rather than a hamstring (another ligament).
After leaving the surgeon’s office and killing time at a coffee shop reading a book, sipping tea, and propping my foot up on a chair (in order to straighten my leg), I had my first official physical therapy appointment. And whereas I was nervous about whether or not I’d jive with the guy, all my fears were immediately laid to rest. He’s awesome. Not only has he been at this for twenty years, but he’s also worked with my surgeon for a long time, and they’re on the same page in terms of objectives and timelines. Plus, he spent a lot of time today really explaining what happened both when I injured myself and during surgery.
“Your ACL is nothing but a tie-down,” he said. “If you had a bicycle with two straps holding it on the back of a trailer, and you cut one strap, the bike would fall over. It’s the same with your knee cap.” Which explains why things felt loose immediately after my injury. My PT (physical therapist) said he’s known people who have lived decades without their ACL, but they end up literally rubbing their bones together, and that causes a lot of problems later in life. “The whole point of the surgery you had is to get you back to doing what you were doing before without additional issues down the line,” he said.
The physical therapy itself wasn’t too complicated. Granted, it was more than I’ve been doing at home, but it wasn’t painful or grit-your-teeth awful. A few stretches, some mini-squats, some leg lifts, some stair-climbing. Then my guy hooked me up to a STEM machine, a device that uses electrical impulses to make your muscles (my quad muscles) twitch and fire. At the same time, he wrapped my knee in another device that was basically a giant leg condom filled with cold water (pumped in by a machine through an attached hose) to reduce swelling. I didn’t take any pictures of this, but here’s a picture of my swollen and bruised leg from this morning. No wonder my ankle’s been hurting.
My PT also explained why my leg has felt achy–because the surgeon used a drill bit as long as my forearm to tunnel through my leg bones. “Oh, that explains it,” I said. Then my PT showed me an animated (not real) video of how the surgery actually went down. Y’all, it’s totally crazy. He took the middle third of my patellar (kneecap) tendon out, along with two pieces of bone attached to it (one at either end; supposedly the holes from which the bones were taken will fill in over time). Then he sewed up the outer two-thirds of my patellar tendon and used that big drill bit to tunnel through my leg on a diagonal. (The ACL and its tie-down buddy, the PCL, criss-cross through the knee–I think.) Then he fished the new ACL through the tunnel and attached the bone pieces to other bones with screws. “That thing ain’t going nowhere,” both my surgeon and my PT said.
Is that wild or what? And seriously, no wonder recovery is a long process. I’ve been cut up and put back together. Along the way, I’ve gained an inch in circumference around my kneecap (from swelling) and lost an inch in circumference around my thigh (from muscle atrophy). “How long will it take to get those muscles built back up?” you might ask. A year. A full year because muscles are made from slow-twitch fibers and fast-twitch fibers, and I can’t use my fast-twitch fibers until six months post-surgery (since they’re the ones used for jumping, sprinting, etc., and that stuff, as already explained, is off-limits). And whereas a week ago this slow recovery process disheartened me, today I’m okay with it, I’m assuming because I have more information than I did before, because I actually understand both what’s happened and what’s happening.
Never underestimate the power of information.
Now if you’ll excuse me, I’m sure there’s a rehab exercise I need to be doing.
Quotes from CoCo (Marcus)
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In other words, there's always SOMETHING else to improve or work on. Therefore, striving for perfection is not only frustrating, it's also technically impossible.
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